Its Amazing how many patients I have that have been hurt at work and are not sure how to proceed.
Workers’ compensation insurance provides medical benefits and wage replacement to employees injured in the course of employment. If you need to file a Workers’ Safety and Insurance Board (WSIB) claim, here are the steps you should follow:
1. Report the Injury or Illness
- Inform Your Employer: Notify your employer about the injury or illness as soon as possible. This should ideally be done in writing and include details like the time, date, and circumstances of the incident.
- Seek Medical Attention: Get medical treatment immediately. Inform the healthcare provider that the injury is work-related, and ensure they record the details accurately. A lot of clinics including ours treat WSIB claims and submit bills directly to WSIB – typically you are coved for 4-8 weeks depending on the severity of the injury.
2. Complete the Necessary Forms
- Employee Forms: Depending on your jurisdiction, you may need to complete a worker’s report form. In Ontario, Canada, this is typically the Form 6 (Worker’s Report of Injury/Disease).
- Employer Forms: Your employer must complete and submit their own form, usually Form 7 (Employer’s Report of Injury/Disease).
3. Submit the Claim
- Submit Forms to WSIB: Send the completed forms to WSIB. Your healthcare provider will also submit a form directly to WSIB.
4. Keep Records
- Documentation: Keep copies of all forms, medical reports, and correspondence related to your claim.
- Communication: Record all communications with your employer, healthcare providers, and WSIB.
5. Follow Up
- Claim Number: Once WSIB processes your claim, you will receive a claim number. Use this number for all future correspondence.
- Case Manager: A case manager may be assigned to your claim. Maintain regular contact with them for updates and guidance.
6. Understand Your Benefits
- Wage Loss Benefits: You may be entitled to a portion of your lost wages.
- Medical Benefits: Coverage for healthcare expenses related to your injury or illness.
- Rehabilitation Services: Support to help you return to work.
7. Appeal If Necessary
- Disputes: If your claim is denied or you disagree with a decision, you have the right to appeal. Review the appeal process specific to your jurisdiction.
Tips for a Successful Claim
- Be Honest and Accurate: Provide truthful and detailed information.
- Meet Deadlines: Adhere to all deadlines for submissions and responses.
- Stay Informed: Educate yourself about your rights and responsibilities under WSIB.
If you encounter challenges or need personalized advice, consider consulting with a workers’ compensation lawyer or a representative knowledgeable in WSIB claims.
